Alcohol: Week 8 Flashcards
3 mechanisms explain alcohol’s ability to cause medical, psychological, and social harm:
physical toxicity
intoxication
dependence
Physical Toxicity
direct and indirect effects on a wide range of body organs and systems
Alcohol related chronic disease
cancer, diabetes, Cardiovascular disease, low birth weight
INTOXICATION
rapid blood alcohol level
results in injuries, accidents, and violence
ALCOHOL DEPENDENCE
impaired control over drinking, high alcohol tolerance, and physical withdrawal symptoms.
impairs a person’s ability to control the frequency and amount of drinking.
When alcohol consumption levels increase in a country, there tends to be an increase in the prevalence of heavy drinkers.
lay terms = the more people drink the more they tend to heavy drink
do alcohol disorders increase or decrease with age ?
decreaseS
Etiologic ModelsOF ALCOHOL (4)
positive affect
negative affect
pharm vulnerability/meds
Deviance proneness/childhood probs
treatment ?
behavioral treatments are likely to be more effective than insight-oriented therapies
do Residential Treatment work?
There is no consistent evidence that intensive in-patient treatment provides more benefit than less intensive outpatient treatment
Residential treatment may be indicated for patients who:
1) are highly resistant to treatment;
2) have few financial resources;
3) come from environments that are not conducive to recovery;
4) have more serious, coexisting medical or psychiatric conditions
Residential treatment may be indicated for patients who:
1) are highly resistant to treatment;
2) have few financial resources;
3) come from environments that are not conducive to recovery;
4) have more serious, coexisting medical or psychiatric conditions
Adjuncts to treatment
Naltrexone (opioid antagonist) & AA
Is Alcohol Treatment Effective?
The intensity and duration of treatment are not associated with outcome.
There is little evidence that any one psychotherapy or pharmacological approach is superior to others
is it better to combine treatment?
Combination with behavior therapy expected to further improve outcomes
Clinical Implications of Therapy Studies
access to treatment
The decision to enter treatment is associated with considerable reductions in drinking
The value of different types of treatment may be to convince clients that treatment is going to help them
Conditions Associated with Alcohol Dependence
suicide
personality disorder
affective disorders
anxiety disorders
do co-morbid cases require more intensive treatment ?
yes because they have a poorer clinical course
Co-morbidity with alcohol use disorders is widespread in general population
52% with alcohol disorder had a lifetime mental disorder
36% had a lifetime drug disorder
Is there relationship between alcohol dependence and psychopathology?
YES
a risk factor for dependence
alter the course of alcohol use disorders
Psychiatric symptoms may be a consequence of drinking
Other Research on The Role of Primary Psychopathology
Externalizing disorders and early-onset anxiety disorders typically precede and predict substance disorders, whereas the temporal-predictive relationships of substance disorders with mood disorders are more variable
Could alcohol dependence be prevented by large-scale interventions aimed at prior mental disorders?
NO
A study said “The number of cases of mental disorder that would have to be treated to prevent a single case of alcohol dependence is estimated to be so high that this would not be cost-effective”
Conclusion about alcohol use and co-morbidy ?
Psychiatric co-morbidity is prevalent in alcoholics
Most depressive, anxiety and psychotic symptomatology remit with abstinence
Excessive drinking can be both a cause and a consequence of psychiatric disorders
‘Upstream’ sources of the damage
Affordable prices
Easy availability
A culture of universal drinking supported by aggressive marketing
Lack of regulatory controls
the effect of Pricing and Taxation of alcohol
increase their drinking when prices are lowered
Increased alcohol taxes and prices are related to reductions
-Alcohol taxes are thus an attractive instrument of alcohol policy because they can be used both to generate direct revenue and to reduce alcohol-related harm.
